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Updates on JAYCS activities and Idiosyncrasies of Japanese cardiac surgery

Mitsuhiro Kawata, MD, PhD, . Shin Takabayashi, MD, PhD,. Hiroo Takayama, MD,. Yasutaka Hirata, MD, PhD, . Kazuma Okamoto, MD, . Hiroyuki Tsukui, MD, PhD, . Naoto Miyagi, MD, PhD, . 13 th Annual Scientific Meeting for ISMICS, 16 – 19 June , 2010, Berlin, Germany.

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Updates on JAYCS activities and Idiosyncrasies of Japanese cardiac surgery

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  1. Mitsuhiro Kawata, MD, PhD, Shin Takabayashi, MD, PhD, Hiroo Takayama, MD, Yasutaka Hirata, MD, PhD, Kazuma Okamoto, MD, Hiroyuki Tsukui, MD, PhD, Naoto Miyagi, MD, PhD, 13th Annual Scientific Meeting for ISMICS, 16 – 19 June , 2010, Berlin, Germany International Fellows Session Updates on JAYCS activities and Idiosyncrasies of Japanese cardiac surgery

  2. Updates on JAYCS activities

  3. Objectives of JAYCS Easy to understand, Our policy is… JAYCS of the young cardiac surgeon, by the young cardiac surgeon, for the young cardiac surgeon. Gettysburg Address by U.S. President Abraham Lincoln

  4. The goals of JAYCS 1. Improve the skills and knowledge of young cardiac surgeons 2. Improve the communication and exchange of information among young cardiac surgeons 3. Enhance the communication between young cardiac surgeons and established surgeons through lectures and teachings 4. Establish mutual respect between young cardiac surgeons and established surgeons 5. Contribute to the improvement of cardiac surgery patient care 6. Obtain global perspective of our specialty Regulations of JAYCS; Oct. 28, 2008

  5. Executives of JAYCS 1. One Representative Director Shin Takabayashi 2. Two Accounting Auditors Hiroo Takayama Naoto Miyagi 3. Up to 15 Directors from nationwide (5 regions) 4. Two Consultants Shinichi Takamoto: President of the JSCVS Shunji Sano: Professor of Okayama University 1 2 3 4 5

  6. Individual Member : young cardiac surgeons ≦ postgraduate year 15 advisors > postgraduate year 16 Membership 1. Cardiac surgeons (Individual Member) 2. Cardiac surgery programs (Institutional Member) 3. Medical companies that endorse the objectives of JAYCS (Supporting Member) 4. Others, such as med. students/nurses… (Homepage Member)

  7. Total number of JAYCS members Members 222 Start: Oct 28 2008

  8. Structure of JAYCS Total: 222 members Work in 136 hospitals including 25 abroad Graduated from 56 medical schools Belong to 43 programs Individual: 180 not belong to programs:31(17%) Adviser: 26 Homepage: 13 Institutional: 3

  9. Programs practice, research, education “A” University program “B” Medical school program director director Dept. of Cardiac surgery director Dept. of Cardiac surgery Chief professor director Chief professor Associate professor Associate professor Associate professor Lecturer Lecturer Lecturer Lecturer Assistant professor Assistant professor Assistant professor Assistant professor Assistant professor Assistant professor Assistant professor Assistant professor Staff Staff Staff Staff Staff Staff Staff Staff Staff Staff graduate student graduate student graduate student graduate student graduate student graduate student graduate student graduate student resident resident resident resident resident resident resident resident medical student medical student

  10. Postgraduate year JAYCS individual members (≦15yrs) Specialty Members 48 99 33 Years

  11. JAYCS activities

  12. Routine Activities of JAYCS • Annual Seminar • 2. Biannual symposium • 3. Frequent informal meetings 4. ISMICS International Fellows Session

  13. JAYCS homepage: 33000 hits • Provide information about • International fellowship • Meetings and seminars • Review of textbooks • 2009 Chief surgeon questionnaire • Ongoing Projects • 1. JAYCS textbook of the cardiac surgery • 2. Discussion Forum in JAYCS homepage • 3. Cannulation technique hands-on seminar • 4. Globalization of cardiac surgery • 5. 2010 Young surgeon questionnaire JAYCS Search Click!

  14. Comments • We have waited for a suitable opportunity. • Now, our main interest is to improve Japanese training system for young cardiac surgeons. • To create better future of cardiac surgery, • we have to • “Reconstruct the training system in Japan”. • At first, to make many people pay attention to the issue, JAYCS will pull a trigger on the meetings in this summer and winter. How to create a nationwide program regulation system?

  15. Cardiac surgery in Japan

  16. 1. Adult cardiac surgery 2. Congenital cardiac surgery 3. For all Japanese cardiac surgeons

  17. 1. Adult cardiac surgery 2. Congenital cardiac surgery 3. For all Japanese cardiac surgeons

  18. Japan Adult Cardiovascular Surgery Database Since 1999 Risk-adjusted Mortality, Items equivalent to STS Database

  19. ・Good outcome of Aortic surgery 4707 records were analyzed from 97 hospitals (between January 1, 2000, and December 31, 2005). Raw 30-day and 30-day operative mortality rates were 6.7% and 8.6%, respectively. Conclusion: ,,,,,,,,the result of this series was excellent. (Circulation. 2008;118[suppl 1]:S153–S159.)

  20. European Journal of Cardio-thoracic Surgery 36 (2009) 517—523

  21. ・Good outcome of Off-pump CABG Gen Thorac Cardiovasc Surg (2009) 57:488–513 • OPCAB (10,979 cases): • 63.4% of the total isolated CABG(17,295 cases) • Primary elective, 30-day mortality 0.7% • Primary emergency, 30-day mortality 4.1% • Redo, emergency, 30-day mortality 4.8%

  22. Ann Thorac Surg 2004;78:1304 –11 J Thorac Cardiovasc Surg 2004;127:1151-7

  23. ・A new device must be introduced over a long time For example, • Commercially available Stent –Graft • Europe • 2000 USA • 2007 Japan TAG: Gore & Associates, Inc. It takes much time to be approved by The Ministry of Health, Labor and Welfare

  24. 1. Adult cardiac surgery 2. Congenital cardiac surgery 3. For all Japanese cardiac surgeons

  25. ・Good outcome of RVOT reconstruction / repair with ePTFE conduit with monocuspid patch Gen Thorac Cardiovasc Surg (2009) 57:488–513 RVOTR (337 cases, Neonate 5, Infant 105, 1-17 years 227): 30-day mortality 0.2%

  26. Ann Thorac Surg 2000;70:1511– 4 no perioperative death good motion of all cusps no or trivial pulmonary regurgitation

  27. J Thorac Cardiovasc Surg 2007;134:327-32 *no mortality, no morbidity *no patients required reoperation during follow-up. *Valve motion was fully maintained in all patients.

  28. 1. Adult cardiac surgery 2. Congenital cardiac surgery 3. For all Japanese cardiac surgeons

  29. Homograft is difficult to obtain.

  30. Japanese Society of Tissue Transplantation since 2001.10.27 West Japan Tissue Transplant Network WJTTN East Japan Tissue Transplant Network EJTTN Cardiac valve and vascular bank Cardiac valve and vascular bank Pancreatic islet bank Pancreatic islet bank Bone bank Bone bank Skin bank

  31. Japanese Society of Tissue Transplantation since 2001.10.27 West Japan Tissue Transplant Network WJTTN East Japan Tissue Transplant Network EJTTN Cardiac valve and vascular bank Cardiac valve and vascular bank Pancreatic islet bank Pancreatic islet bank Bone bank Bone bank Skin bank

  32. donor recipient donor recipient

  33. Postoperative care in ICU or CCU is mainly the task of cardiac surgeons. Intensivists for post cardiac surgery are definitely rare. Advantage? Disadvantage?

  34. Let’s do our Best for our Patients. Let’s Challenge Together !!!

  35. Thank you for your attention! .. Danke schon!

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